Heart failure doesn’t mean your heart has stopped working. It just isn’t pumping blood as well as it should.
Recent treatment advances can help your ticker work better, keep you out of the hospital, and improve your quality of life.
High-tech implants can help your doctor check how your heart is doing in real time, so you can adjust your medications to feel better quickly. Research on new blood and genetic testing may soon make it easier for doctors to diagnose heart failure earlier or spot who’s most at risk for it.
“Heart failure is no longer about ‘failure,’” says Clyde W. Yancy, MD, chief of cardiology at Northwestern University. “The array of medical and device therapies, and the insight we now have regarding prevention, makes this both a preventable and treatable condition.
“The outlook for those with heart failure has never been better.”
New Drug Treatments
Heart failure medicines can help you live longer, feel better, or treat your symptoms. To lower your blood pressure or slow your heart rate, you may take:
- ACE inhibitors
- Angiotensin II receptor blockers (ARBs)
- Aldosterone antagonists, which help your body get rid of salt and water
- Diuretics, sometimes called “water pills”
Two new heart drugs can also help lower your chances of hospital visits because of your heart failure.
Ivabradine (Corlanor). This medication slows your heart rate. It may also cut your time in the hospital, says Brian Lowes, MD, PhD, chairman of cardiology at the University of Nebraska Medical Center.
It may be right for you if:
- Your heart failure is caused by problems in your heart’s lower left chamber
- You have a normal heartbeat
- Your heart rate isn't controlled by beta-blockers or you can't take them
Sacubitril/Valsartan (Entresto). This is the first FDA-approved medication in a new class of drugs called angiotensin receptor neprilysin inhibitors (ARNIs). Lowes says this combination of two heart drugs can shorten your time in the hospital.
You’ll probably also keep taking other heart meds with this new treatment, but it can’t be used with ACE inhibitors.
Sodium-glucose cotransporter 2 inhibitor (SGLT2i). This drug was developed to treat diabetes. In studies, SGLT2i also has shown promise in lowering death and hospitalization for heart failure in people with heart failure with or without diabetes.
Implants and Heart Pumps
Using meds to manage heart failure isn’t the best choice for everyone. Devices like the ones described below can help your heart beat more efficiently and may be a good option for you.
Implantable cardioverter defibrillator. This gives your heart an electric shock when it senses a life-threatening change in rhythm. Newer models are implanted under your skin, and they don’t require leads or wires through your veins.
Cardiac resynchronization therapy. A type of pacemaker, this tiny, implanted device helps your heart beat in a regular rhythm. A new type can send electric pulses to more spots on your ticker’s surface. This will mean you won’t need to have it adjusted as much.
Pacemakers are also being improved. One being tested now that's not yet available is smaller than current ones. It’s also wireless, and it can be put in through a leg vein instead of by an incision in your chest.
Implantable monitor. It lets doctors monitor your heart and adjust your treatment, Lowes says.
It measures the pressure on your arteries and your heart rate. It’s about the size of a small paper clip, and it’s inserted into an artery without the need for batteries or wires.
Lowes says this allows you to monitor yourself at home. This can help keep you out of the hospital and improve your quality of life.
Total artificial heart. This is an option for people with severe heart failure who need a transplant. It can be implanted into your heart to replace the lower two chambers that can no longer pump blood effectively. It has an outside power source. It is still in research phase and is not yet widely available.
Left ventricular assist device (LVAD). Your left ventricle is the big chamber on the left side of your heart. It pumps blood throughout your body. An LVAD is a pump that’s implanted into the left ventricle with tubes that pull blood in and out of the heart. It can help your ticker pump blood when it’s too weak to do it on its own.
It’s hooked to a battery you carry outside of your body. If you’re set to get a heart transplant, an LVAD can keep your heart working until your procedure.
Heart pumps are getting smaller, easier to implant, longer lasting, and better matched with your blood, Lowes says. Newer LVADs also pump blood continuously, which makes them more efficient than older options.
New Surgeries and Tests
Another advance is reconstruction surgery, which can reshape your heart so it pumps blood easier. Your doctor may be able to repair the valves. This can make your heart smaller so it works better.
New tests can help doctors spot heart failure earlier or track your progress, Lowes says. Genetic testing may predict who’s at risk for the condition or other problems, like atrial fibrillation, that could raise your odds of heart failure.
Newer blood tests can help your doctor make an early diagnosis and see if your drugs are causing problems. One such test is to check your level of troponin. The more of this you have, the more damage has been done to your heart.
No matter which treatments you use, you can do a lot to live longer and have a better quality of life, says Mary Norine Walsh, MD, medical director of the heart failure and cardiac transplantation programs at St. Vincent Heart Center of Indiana.
“The first step is taking medications as directed, on time and every day,” she says. “Most patients can monitor their weight every day to help check if their fluid status is changing. All patients can benefit from a diet that’s low in sodium, too.
“All of these steps can have a big impact on your quality of life with heart failure.”